Male Hormonal Birth Control Side Effects (Episode 470)

Full Transcript: Episode 470

Lisa Hendrickson-Jack: Welcome to the Fertility Friday Podcast, your source for information about the fertility awareness method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Training Workbook. I’m a certified fertility awareness educator and holistic reproductive health practitioner with over 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormone health, and optimizing the menstrual cycle without hormones.

I’ve been consistently outspoken about hormonal birth control over the past two decades and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies.

I’m also a wife and mother of two beautiful boys and a brand new baby girl. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with me today.

Today I’m sharing a brand new episode in my FAM Research Series. I’m sharing an interesting study that I highlighted in The Fifth Vital Sign. If you have a copy of the book, it’s in chapter seven, page 111. This is a particularly interesting study because it addresses the question of what would happen if men experienced the same side effects on birth control that women experience every single day.

In many ways, this study puts that question to rest because it’s essentially the same thing. We’re going to get into the study, talk through what happened, and by the end of this episode you’ll be very familiar with it. It’s an interesting piece of information to ponder, and it makes me think about the state of medicine, medical gaslighting, and how women’s issues often are not taken as seriously.

The title of the research study we’re getting into today is Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men. This was a study on an injectable contraceptive for men, similar to the Depo shot that’s used for women. The study was published in 2016, and I’ll start by walking you through what the researchers were trying to determine.

The intention of the study was to see whether this contraceptive option could be viable for men. There is an unmet need in the market for male hormonal contraceptives. At present, the only contraceptive options available to men are condoms, sterilization, or withdrawal. The study explicitly states that the development of a safe, effective, and reversible method of male contraception remains an unmet need.

The researchers selected a group of healthy men between the ages of 18 and 45. All participants met World Health Organization guidelines for normal sperm parameters at baseline. Over the course of the study, participants received injections every eight weeks containing a combination of synthetic progestins and testosterone.

The researchers measured sperm parameters to determine whether the injections successfully suppressed sperm production. They also tracked pregnancy rates. Overall, 95.9 percent of participants experienced suppression of sperm concentration to less than one million per milliliter within 24 weeks. In practical terms, this meant the vast majority of men reached levels considered functionally infertile.

During the efficacy phase, which lasted up to 56 weeks, four pregnancies occurred among the partners of 266 men. This resulted in a pregnancy rate of 1.57 per 100 users, which is comparable to the perfect-use efficacy rates of female hormonal contraceptives.

From an efficacy standpoint, the trial was a success. The injectable method effectively suppressed sperm production and demonstrated a high level of pregnancy prevention.

The most commonly reported adverse reactions included acne, pain at the injection site, increased libido, and mood disorders. When you look at these side effects, they closely mirror the experiences reported by women using hormonal contraceptives such as the pill, patch, shot, ring, or hormonal IUD.

For women, common side effects of hormonal contraception include changes in libido, mood changes such as anxiety and depression, and acne. On the surface, the side effect profile in this male contraceptive study was remarkably similar.

What makes this study especially notable is that it was stopped early. An independent data and safety monitoring committee had been established before the trial began. Midway through the study, the committee determined that the side effects were severe enough to warrant stopping recruitment and discontinuing injections for enrolled participants.

The study reported that some participants experienced significant mood changes and depression. The committee decided that participants should be transitioned into the recovery phase rather than continuing injections.

This raises broader questions about how we evaluate risk and side effects in contraceptive research. If many people have concerns about the impact of hormonal contraceptives on mood, libido, or other aspects of health, does it make sense to create an analogous hormonal option for men?

Suppressing sperm production requires altering testosterone regulation. Even when synthetic hormones are provided, natural hormone production changes, and those changes can have emotional and physical effects. This is consistent with what we already know about how hormonal contraceptives affect women.

The central question of this episode is whether side effects are perceived differently depending on who experiences them. There has never been a safety committee that halted hormonal contraceptive use for women, despite extensive documentation of side effects.

Studies show that about half of women who start the pill discontinue use within the first year, often because of side effects. Many women switch from one contraceptive to another in search of something with fewer adverse effects.

In this study, 266 men were enrolled, and the trial was stopped before completion due to side effects that closely resemble those experienced by women every day. That contrast is central to why this research is so compelling.

The study also reported that 20 men discontinued participation due to product-related side effects. Some discontinued solely because of mood changes, while others cited acne, pain, panic at injection, palpitations, hypertension, or erectile dysfunction. Eight participants discontinued due to multiple side effects.

The study further reported one death by suicide during the efficacy phase. The participant had received three injections and died one month after the final injection. The death was assessed by the researchers as not related to the study regimen, though it underscores the seriousness of the reported mood effects.

These side effects—depression, mood changes, sexual dysfunction, and changes in libido—are commonly reported by women using hormonal contraceptives. Yet when men experienced similar effects, the study was stopped to protect participants.

This leads to the broader question of why similar side effects are considered acceptable for women. Hormonal birth control has been in widespread use for decades, despite documented risks and serious adverse outcomes for a subset of users.

The study demonstrates that the technology to create a hormonal contraceptive for men already exists. The primary barrier is not efficacy, but tolerability of side effects.

Women continue to carry the majority of the reproductive burden when it comes to birth control decisions. Many women discover fertility awareness because they are seeking non-hormonal options after experiencing side effects from contraceptives.

For some women, fertility awareness offers relief by providing an effective, non-hormonal option that supports understanding the menstrual cycle. Others are interested in learning more about their cycles or preparing their bodies for future conception.

This study invites reflection on how reproductive health research evaluates risk, whose side effects are prioritized, and why women’s experiences are often minimized or dismissed.

I find this study both fascinating and frustrating. It is an important conversation piece and highlights that concerns women raise about hormonal birth control are not imagined or exaggerated.

If men experienced the same side effects, the response would be different. In this case, a safety committee intervened and shut the study down.

Thank you so much for listening. If you know someone who would find this discussion interesting, you can share the episode at fertilityfriday.com/470. I’ll let you go and hope you enjoy the rest of your day.